Get a Library Card

Name

Last

First

Middle Initial

How you you like to be contacted about your account

Phone

Text

Phone

Carrier for Text Messaging

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Township

Driver’s License or State ID

Birthdate

Patron Agreement

By signing up for a Cromaine library card online, I agree to obtain responsibility for all materials borrowed against my card. I will notify the library immediately if my address changes or if my card is lost.

Statement of Financial Responsibility

I certify that the information on the form is correct. I accept responsibility for those materials borrowed on the library card issued from this application. Responsibility for the choice of materials borrowed rests with the person(s) whose signature(s) appear on the line below and not with library system or staff.

Statement of Residency

I certify that I am a resident of the Hartland school district.

I certify that I am the parent/legal guardian of the minor applying for a card.

Parent/Guardian's First Name

Parent/Guardian's Last Name

Information Release

I, the individual named above in this application, do hereby grant permission to the Cromaine District Library to release information regarding my library records, as well as permission to pick up items reserved in my name, to the following person(s):

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